MAPI Research Trust provides reliable, comprehensive and up-to-date information services to research scientists, pharmaceutical companies, and governmental health agencies involved in the fields of Patient-Reported Outcomes (PRO) and Epidemiology worldwide.
Home
CONFIDENTIAL DISCLOSURE

LIMITED USE AGREEMENT

for the Pediatric Quality of Life InventoryTM PedsQLTM Diabetes module version 3.0
(PedsQLTM Diabetes module version 3.0™)

THIS AGREEMENT WILL EXPIRE 7 DAYS AFTER RECEIPT.
THE COPY OF THE PedsQLTM Diabetes module version 3.0 SUPPLIED WITH THIS AGREEMENT MAY ONLY BE USED FOR EXAMINATION PURPOSES.
To view the questionnaire, please complete the following form:
Gender Male     Female
First Name
Last Name*
Company
Position
Title
Address*
Zip / Postal Code*
City*
State / Province
Country*
Phone
Fax
Email*
* required field


The information which concerns you is intended for Mapi Research Trust and its affiliates. It helps us to get to know you better and will be used to keep you informed of our products and services.
If you object, please tick this box

You have the right to access , modify , rectify and delete any data that concern you (art. 34 - Law "Informatique et Libertes" of January 6, 1978 - Data Protection). To exercise this right, contact Mapi Research Trust, 27 rue de la Villette, 69003 Lyon, France.

YOUR ACQUISITION OF AN EXAMINATION COPY OF PEDSQLTM DIABETES MODULE VERSION 3.0 SIGNIFIES YOUR FULL AGREEMENT TO THE FOLLOWING CONDITIONS:

This License Agreement is for your limited use of the Pediatric Quality of Life InventoryTM PedsQLTM Diabetes module version 3.0 (PedsQLTM Diabetes module version 3.0™) , copyright ©1998, JW Varni, PhD, All Rights Reserved.

This Agreement provides you with a personal, non-transferable, royalty-free, non-exclusive right and license to use the PedsQLTM Diabetes module version 3.0 for limited purpose of examining the suitability of the PedsQLTM Diabetes module version 3.0 for subsequent research and/or clinical use. This Agreement does not include: (1) any license for use of the PedsQLTM Diabetes module version 3.0 in research or in clinical practice(2) any license to sell or sublicense use of the PedsQLTM Diabetes module version 3.0 . The PedsQLTM Diabetes module version 3.0 may be examined only by persons whom you employ or whom you engage as independent contractors. You assume all risk for use of the PedsQLTM Diabetes module version 3.0. This License only entitles you to obtain and use, for examination purposes, a single copy of the PedsQLTM Diabetes module version 3.0.

You are not authorized to modify, retype, translate, copy or otherwise duplicate the PedsQLTM Diabetes module version 3.0 except with the further and prior written permission of LICENSOR (Mapi Research Trust on behalf of Dr. James Varni).

To access our catalog, please click here.

New questionnaires distributed by MAPI Research Trust

ACCEPT (Chronic Treatment Acceptance Questionnaire)
MAPI SAS / Registrat MAPI (France)

ADRQL (Alzheimer Disease Related Quality of Life)
Black Betty S, Kasper Judith D and Rabins Peter V. - Johns Hopkins Medical INstitutions (USA)

Barthel Index questionnaire
The Maryland State Medical Society - MedChi (USA)

ESS (Epworth Sleepiness Scale) 
Murray W. Johns (Australia)

FIRST (Fibromyalgia Rapid Screening Tool)
Serge Perrot & Didier Bouhassira (France)

PDSS-2 (Parkinson's Disease Sleep Scale)
Ray Chaudhuri (UK) & Claudia Trenkwalder (Germany)

Skindex questionnaire 
Mary-Margaret Chren (USA)

TRIM-D and TRIM-D Device (Treatment Related Impact Measure for Diabetes)
Novo Nordisk (Denmark)